Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,045.60 / $4,795.20 / $17,852.40	Facility		$3,045.60	$4,795.20	$17,852.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,988.53 / $3,142.80 / $4,795.20	Professional		$1,988.53	$3,142.80	$4,795.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,402.00 / $5,184.00 / $13,385.74	Facility		$3,402.00	$5,184.00	$13,385.74
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,916.00 / $6,330.34 / $24,300.00	Professional		$2,916.00	$6,330.34	$24,300.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,369.60 / $6,887.25 / $8,424.00	Facility		$3,369.60	$6,887.25	$8,424.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,637.80 / $3,633.06 / $4,420.28	Professional		$1,637.80	$3,633.06	$4,420.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,197.34 / $4,094.55 / $10,022.10	Facility		$3,197.34	$4,094.55	$10,022.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,240.00 / $4,762.80 / $8,966.37	Professional		$3,240.00	$4,762.80	$8,966.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,240.00 / $3,240.00 / $6,804.00	Facility		$3,240.00	$3,240.00	$6,804.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,240.00 / $5,670.00 / $9,720.00	Facility		$3,240.00	$5,670.00	$9,720.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,916.00 / $4,050.00 / $4,892.39	Professional		$2,916.00	$4,050.00	$4,892.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,402.00 / $5,316.84 / $8,910.00	Facility		$3,402.00	$5,316.84	$8,910.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,583.44 / $6,304.88 / $7,533.34	Professional		$3,583.44	$6,304.88	$7,533.34
United Facility/Professional Professional Modifier Low / Median / High Price $1,193.11 / $1,360.80 / $3,628.80	Professional		$1,193.11	$1,360.80	$3,628.80